Current Research Gaps and Priorities in Nutrition in Emergencies

Background:

Global Thematic Working Groups (GTWGs), provide a platform for developing timely consensus-driven stop-gap guidance in response to key technical gaps identified by the Alliance. Thematic areas covered by the GTWGs currently include child wasting prevention and treatment, Infant Feeding in Emergencies (IFE), Nutrition Information Systems (NIS), management of small and nutritionally at-risk infants under six months of age and their mothers (MAMI) and Cash and Voucher Assistance (CVA) for nutrition outcomes. The technical and knowledge gaps in each of these areas are partly due to a lack of nutrition research in emergency settings. This impedes practitioner-level understanding of appropriate evidence-based responses for different and changing contexts, which could improve the effectiveness of nutrition in emergency programming. While there has been a sizable increase in studies looking at the efficacy and effectiveness of nutrition in emergency programming, large knowledge gaps remain. The multiple forms of malnutrition present in emergency contexts are not distinct from other settings. However, the scale and urgency of required actions and the challenges faced by programmes is different. Building the evidence base for effective nutrition in emergency interventions can be logistically and ethically challenging. Furthermore, where research has been conducted, there are often challenges around adequate data quality which impacts overall research findings and subsequent programmatic recommendations.

At the 2021 GNC annual meeting, this lack of nutrition research in emergency settings and its impact on practitioner-level responses was highlighted. During the meeting, attendees reflected on the possible role the GNC could have in highlighting these research needs more broadly. Subsequently, the activity to do a light touch research mapping was included in the GNC 2022-2025 strategy. Given that this work was more technical in nature, the Alliance was asked to carry out this activity. Emergency Nutrition Network (ENN), in its oversight role of the GTWGs within the Alliance, undertook this exercise between August 2022 and January 2023.

Key findings:

In 2022, it was estimated that over 274 million people would require humanitarian assistance, the highest figure in decades. With such a high burden and scarce resources, it’s essential that we can demonstrate long term impact and cost effectiveness of nutrition in emergencies programming. This would enable a better more evidence-based response that maximises impact for affected populations. This report aims to summarise key research gaps across infant and young child feeding in emergencies, nutrition information systems, wasting, management of small and nutritionally at-risk infants and their mothers, and cash and voucher assistance for nutrition outcomes to help better inform and encourage researchers, non-governmental organisations and donors involved in conducting nutrition in emergencies research.

• While there has been an increase in nutrition in emergency research, important knowledge gaps remain both within each of the thematic areas as well as more generally with a lack of research on nutrition information systems and impact of cash and voucher assistance on children’s and women/girls’ nutritional status in emergency contexts being highlighted. This review also identified a need for more research on interventions to improve the identification and management of small/nutritionally at-risk infants and their mothers, prevention of wasting including through improving preconception nutrition, the need to further understand and identify children most at risk of adverse outcomes associated with wasting, management of breastmilk substitutes, re-lactation and complementary feeding.
• A critical challenge for nutrition in emergencies research is the lack of high-quality research, which has limited its ability to fully answer key questions and affect change in guidance and policy. At the same time, it’s essential that research is designed to answer practical questions that exist on intervention design, feasibility and cost-effectiveness to support programme implementation.
• Overall, across thematic areas, further investment is needed to strengthen the quality and breadth of nutrition in emergency research. Consensus on the most important gaps need to be better articulated by practitioners and be more visible to researchers looking to conduct research in emergency settings.

Read the full report here